期刊论文详细信息
BMC Pregnancy and Childbirth
Eating for 1, Healthy and Active for 2; feasibility of delivering novel, compact training for midwives to build knowledge and confidence in giving nutrition, physical activity and weight management advice during pregnancy
Sharn Jones2  Karen Tocque1  Lynne Kennedy3  Andrea Basu2 
[1] KT Intelligence CIC/University of Chester, Regus House, Herons Way, Chester Business Park, Chester CH4 9QR, UK;Betsi Cadwaladr University Health Board, Wrexham Maelor Hospital, Croesnewydd Road, Wrexham LL13 7TD, UK;Department of Clinical Sciences & Nutrition, University of Chester, Parkgate Road, Chester CH1 4BJ, UK
关键词: Training;    Obesity;    Physical activity;    Weight management;    Nutrition;   
Others  :  1127176
DOI  :  10.1186/1471-2393-14-218
 received in 2013-10-18, accepted in 2014-06-24,  发布年份 2014
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【 摘 要 】

Background

Women in Wales are more likely to be obese in pregnancy than in any other United Kingdom (UK) country. Midwives are ideally placed to explore nutrition, physical activity and weight management concerns however qualitative studies indicate they lack confidence in raising the sensitive issue of weight. Acknowledging this and the reality of finite time and resources, this study aimed to deliver compact training on nutrition, physical activity and weight management during pregnancy to increase the knowledge and confidence of midwives in this subject.

Methods

A compact training package for midwives was developed comprising of evidence based nutrition, physical activity and weight management guidance for pregnancy. Training was promoted via midwifery leads and delivered within the Health Board. Questionnaires based on statements from national public health guidance were used to assess changes in self-reported knowledge and confidence pre and post training. Descriptive statistics were applied and 95% confidence intervals were calculated.

Results

43 midwives registered for training, 32 (74%) attended and completed the questionnaires. Although, pre training knowledge and confidence varied between participants, statistically significant improvements in self-reported knowledge and confidence were observed post training. 97% indicated knowledge of pregnancy specific food and nutrition messages as ‘better’ (95% CI 85 to 100), as opposed to 3% stating ‘stayed the same’ – 60% stated ‘much better’. 83% indicated confidence to explain the risks of raised BMI in pregnancy was either ‘much’ or ‘somewhat better’ (95% CI 66 to 93), as opposed to 17% stating ‘stayed the same’. 89% indicated confidence to discuss eating habits and physical activity was ‘much’ or ‘somewhat better’ (95% CI 73 to 97) as opposed to 11% stating ‘stayed the same’. Emergent themes highlighted that training was positively received and relevant to midwifery practice.

Conclusions

This study provides early indications that a compact nutrition, physical activity and weight management training package improves midwives self-reported knowledge and confidence. Cascading training across the midwifery service in the Health Board and conducting further studies to elicit longer term impact on midwifery practice and patient outcomes are recommended.

【 授权许可】

   
2014 Basu et al.; licensee BioMed Central Ltd.

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【 参考文献 】
  • [1]Centre for Maternity and Child Enquiries (CMACE): Maternal Obesity in the UK: Findings from a National Project. London: CMACE; 2010.
  • [2]Jones S: BMI records of women at initial antenatal assessment. In Personal Communication. Betsi Cadwaladr: University Health Board; 2012.
  • [3]Modder J, Fitzsimon K: CMACE/RCOG Joint Guideline:Management of Women With Obesity in Pregnancy. London: Centre for Maternity and Child Enquiries/Royal College ofObstetricians and Gynaecologists (CMACE/RCOG); 2010.
  • [4]Wojcicki JM: Maternal Prepregnancy body mass index and initiation of breastfeeding: a review of the literature. J Womens Health 2011, 20(3):341-347.
  • [5]Rasmussen KM, Dieterich CM, Zelek SL, Altabet JB, Kjolhede CL: Interventions to increase the duration of breastfeeding in obese mothers: the Bassett Improving Breastfeeding Study. Breastfeed Med 2011, 6(2):69-75.
  • [6]National Institute for Health and Clinical Excellence (NICE): Weight management before, during and after pregnancy. In NICE Public Health Guidance 27. London: NICE; 2010.
  • [7]Confidential Enquiry into Maternal and Child Health (CEMACH): Why Mothers Die 2000–2002. In The Sixth Report of the Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH; 2004.
  • [8]Centre for Maternity and Child Enquiries (CMACE): Saving mothers’ lives: reviewing maternal deaths to make motherhood safer- 2003–2005. In The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH; 2007.
  • [9]Centre for Maternity and Child Enquiries (CMACE): Perinatal Mortality 2009. London: CMACE; 2011.
  • [10]Russell S, Fyle J, Da Costa-Fernandes M, Stockdale J: Weight a growing problem. Does weight matter in pregnancy? Netmums Royal Coll Midwives 2010. available from [http://www.netmums.com/home/netmums-campaigns/maternity-services-experiences-of-mums/a-growing-problem-weight-in-pregnancy webcite], accessed 24th June 2013
  • [11]Furness PJ, McSeveny K, Arden MA, Garland C, Dearden A, Soltani H: Maternal obesity support services: a qualitative study of the perspectives of women and midwives. BMC Pregnancy Childbirth 2011, 11:69.
  • [12]Laraia BA, Bodnar LM, Siega-Riz AM: Pregravid body mass index is negatively associated with diet quality during pregnancy. Public Health Nutr 2007, 10(9):920-926.
  • [13]de Jersey SJ, Nicholson JM, Callaway LK, Daniels LA: An observational study of nutrition and physical activity behaviours, knowledge, and advice in pregnancy. BMC Pregnancy Childbirth 2013, 13:115.
  • [14]Hestlehurst N, Moore H, Rankin J, Ells LJ, Wilkinson JR, Summerbell CD: How can maternity services be developed to effectively address maternal obesity? A qualitative study. Midwifery 2011, 27(5):e170-e177.
  • [15]Smith D, Lavender T: The maternity experience for women with a body mass index of ≥30 kg/m2: a meta-synthesis. Br J Obstet Gynaecol 2011, 118:779-789.
  • [16]Furber CM, McGowan L: A qualitative study of the experiences of women who are obese and pregnant in the UK. Midwifery 2011, 27(4):437-444.
  • [17]Nyman VMK, Prebensen AK, Flensner GEM: Obese women’s experiences of encounters with midwives and physicians during pregnancy and childbirth. Midwifery 2010, 26(4):424-429.
  • [18]Powell J, Hughes C: Antenatal interventions that support obese pregnant women. Br J Midwifery 2012, 20(6):325-331.
  • [19]Heslehurst N, Russell S, McCormack S, Sedgewick G, Rankin J: Midwives perspectives of their training and education requirements in maternal obesity: A qualitative study. Midwifery 2012, 29(7):736-744.
  • [20]Macleod M, Gregor A, Barnett C, Magee E, Thompson J, Anderson AS: Provision of weight management advice for obese women during pregnancy: a survey of current practice and midwives’ views on future approaches. Midwifery 2012, 9(4):467-472.
  • [21]Wilkinson SA, Poad D, Stapleton H: Maternal overweight and obesity: a survey of clinicians’ characteristics and attitudes and their responses to their pregnant clients. BMC Pregnancy Childbirth 2013, 13:117.
  • [22]Welsh Government: A Strategic Vision for Maternity Services in Wales. Cardiff: Welsh Government; 2011.
  • [23]Britt E, Hudson SM, Blampied NM: Motivational interviewing in health settings: a review. Patient Educ Couns 2004, 53:147-155.
  • [24]Hardcastle SJ, Taylor AH, Bailey MP, Harley RA, Hagger MS: Effectiveness of a motivational interviewing intervention on weight loss, physical activity and cardiovascular disease risk factors: a randomised controlled trial with a 12-month post-intervention follow- up. Int J Behav Nutr Phys Act 2013, 10:1-16.
  • [25]Miller WR, Rollnick S: Motivational Interviewing. Helping People Change. 3rd edition. New York: Guilford Press; 2013.
  • [26]Department of Health: Delivering Expectations Midwifery 2020. London: Department of Health; 2010.
  • [27]NHS Wales Shared Services Partnership: Welsh Risk Pool Clinical Area 1, Maternity 2011–12. [http://howis.wales.nhs.uk/sites3/Documents/287/Clinical%20Area%201%20-%20%20Maternity%20Services%202011-12.doc webcite], accessed 23/08/2013
  • [28]Olander EK, Atkinson L, Edmunds JK, French DP: The views of pre- and post-natal women and health professionals regarding gestational weight gain: an exploratory study. Sex Reprod Health 2011, 2(1):43-48.
  • [29]Institute of Medicine: Weight Gain During Pregnancy: Reexamining the Guidelines. Washington, D.C: The National Academies Press; 2009.
  • [30]Poston L: How should women be advised on weight management in pregnancy. BMJ 2012, 344:1-3.
  • [31]Gunderson EP: Childbearing and obesity in women: Weight before during and after pregnancy. Obstet Gynecol Clin North Am 2009, 36(2):317-ix.
  • [32]Butland B, Jebb S, Kopleman P, McPherson K, Thomas S, Mardell J, Parry V: Foresight, Tackling Obesities, Future Choices. In Project Report. 2nd edition. London: Government Office for Science; 2007.
  • [33]Betsi Cadwaladr University Health Board (BCUHB)About us [http://www.wales.nhs.uk/sitesplus/861/home webcite], accessed01/08/13
  • [34]Welsh Government: Births in Wales 2001–11: Data from the National Community Child Health Database Statistics for Wales. [http://wales.gov.uk/docs/statistics/2012/120724sdr1142012en.pdf webcite], accessed 22/08/13
  • [35]Welstand J, Carson A, Rutherford P: Living with heart failure: an integrative review. Int J Nurs Stud 2009, 46(10):1374-1385.
  • [36]Mason P, Butler CC: Health Behaviour Change. 2nd edition. Edinburgh: Churchill Livingstone Elsevier; 2010.
  • [37]Trochim WM: Likert Scaling. Research Methods Knowledge Base, Web Center for Social Research Methods; 2006. [http://www.socialresearchmethods.net/kb/scaling.php webcite], accessed 14/02/2014
  • [38]NHS Health Research Authority: is my Study Research?. [http://www.hra-decisiontools.org.uk/research/ webcite], accessed 01/04/2014
  • [39]Clarke V, Braun V: Teaching thematic analysis. Psychologist 2013, 26(2):120-123.
  • [40]Cheetham G, Chivers G: How professionals learn in practice: an investigation of informal learning amongst people working in professions. J Eur Ind Train 2001, 25(5):247-292.
  • [41]National Institute for Health and Clinical Excellence (NICE): Antenatal care-routine care for the healthy pregnant woman. In NICE Clinical Guideline 62. London: NICE; 2008.
  • [42]McNeil J, Doran J, Lynn F, Anderson G, Alderdice F: Public health education for midwives and midwifery students: a mixed methods study. BMC Pregnancy Childbirth 2012, 12:142.
  • [43]Oelofsen N: Using reflective practice in front line nursing. Nurs Times 2012, 108(24):22-24.
  • [44]British Dietetic Association (BDA): The Role of Dietitians. [http://www.bda.uk.com/ webcite], accessed 23/08/13
  • [45]Welsh Government: Welsh Health Survey, 2012: Initial Headline Results. [http://wales.gov.uk/statistics-and-research/welsh-health-survey/?lang=en webcite], accessed 25/09/2013
  • [46]Lakha F, Glasier A: Unintended pregnancy and use of emergency contraception among a large cohort of women attending for antenatal care or abortion in Scotland. Lancet 2006, 368(9549):1782-1787.
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